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Neuropsychological Differentiation of Alzheimer’s Disease and Vascular Dementia: A Meta-Analysis Jennifer Burke University of Adelaide Associate Professor Jane Mathias University of Adelaide

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Background The differential diagnosis of Alzheimer’s Disease (AD) and vascular dementia (VaD) is difficult Cognitive assessments play an important role in differential diagnosis There is a lack of clear evidence regarding which cognitive tests accurately discriminate between AD and VaD

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Aim Undertake a meta-analytic review of research comparing the cognitive deficits of persons with AD and VaD

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Inclusion criteria 1. Examined groups with AD & VaD 2. Cognitive tests were administered to both groups 3. These tests were not used for diagnosis 4. Data enabling the calculation of effect sizes 5. Participants did not have any other neurological or psychiatric disorder 6. Was published in English

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Calculations Mean effect sizes were then calculated for all studies that used a given measure Mean effect sizes were then calculated for all studies that used a given measure Effect sizes were weighted to take into account sample size Effect sizes were weighted to take into account sample size

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Calculations Percentage overlap in scores (%OL) 95% confidence intervals Fail-safe N – measures Fail-safe N – measures the number of studies with small effects that are required to overturn a finding Heterogeneity was tested

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Results d ranged from 0 to 1.1 %OL ranged from 40 to 100 At best, cognitive tests are limited in their ability to discriminate between AD & VaD

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Results Tests examined by one study –13 cognitive tests showed large group differences Commonly used tests did not effectively discriminate between AD and VaD patients

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Conclusions Cognitive tests must be used cautiously and in conjunction with other diagnostic information –Inadequate diagnostic criteria –VaD is a heterogeneous disease –Overlapping aetiologies There are a number tests that may prove suitable for assisting with differential diagnosis